People with mental health problems look as diverse as the society we live in - not like some hybrid of Eeyore and Edvard Munch’s The Scream

As a mental health campaigner, I’m usually happy to work with journalists who ask me to share my own story in order to highlight a subject I believe in passionately. Whether it’s calling for better access to eating disorders services, a greater focus on mental health in schools, or the need to address suicide rates in men, I lend my voice in the hope that things might change.

I always have a nervous moment whenever a story is released. I read the item with urgency, checking how I’ve been quoted and the context of the finished piece. Then there’s the anxiety to share the piece on social media, the ambivalence as you wait for responses to come in via Twitter. But more often than not, I also experience frustration. Not confined to being misquoted or feeling a key point has been missed out, my exasperation is at the cliched images that are nearly always used to accompany articles about mental health.

One of the most common of these images is the “head-clutching” photo, where a gloomily-lit scene shows a despairing victim grasping miserably at their hairline. Like some hybrid of Edvard Munch’s The Scream and Eeyore, these images of distress and despondency tell us that “this is what mental health problems look like”. Similarly with eating disorders, the day I give an interview that isn’t published alongside a picture of a pale girl hovering fearfully over weighing scales, in front of a mirror, or suspiciously eying an apple, I will eat my hat (and I won’t make myself sick after, promise).

The problem with head-clutching photos and other cliched representations of mental health problems is that they do not really represent anyone. They certainly don’t represent the way in which most people show themselves to the world, even when under a cloud of emotional distress or debilitating psychological symptoms. People with mental health problems not only look as diverse as the society we live in - they can also look perfectly functional, healthy and even happy.

One of the great powers of mental health problems and psychological distress is their potential to be invisible. The fact that people can live with severely life-limiting states of mental health without anyone else knowing otherwise is in-part responsible for how people need to prove they’re ill in order to receive benefits, or are denied treatment when their eating disorder doesn’t come with the visible symptom of being underweight. The frequent invisibility of mental health is why we say “I had no idea they were unhappy” when someone we perceive as “well” completes suicide.

When in the depths of anorexia, I was once asked by a psychiatrist: “Why do you want to look like that? Only girls want to lose weight”. Surprisingly I didn’t suddenly remember I had a penis and order a steak and chips. I felt shocked and alienated, that because I didn’t fit the vision of anorexia in popular culture, somehow my problem was perceived as less real. I remember, after waiting 4 months for a psychiatric assessment and struggling with suicidal thoughts day after day, reading with shock the consultation report which said I “seemed reactive and engaged” with “no signs of anhedonia” (the inability to enjoy or take pleasure in things, as seen in depression). Of course I was engaged, I was desperately lonely and utterly relieved to talk to someone. Seeing the psychiatrist was effectively my social engagement of the year. Yet because I was unable to give a face-to-face insight into the depths of my despair, I left without the support I needed, which only came after I attempted suicide a few weeks later. If mental health professionals sometimes struggle to recognise the diversity of how mental health problems look, then no wonder the rest of us struggle.

Maybe my taking issue with the media’s perpetuation of a fixed idea of what mental health problems is being a bit over-reactive to what might seem a benign issue. But the potential for harm comes when people feel alienated and unrepresented by these images. The potential for harm is when someone reads an article captioned with a bleak head-clutching scene and thinks that their experience of depression and anxiety must be invalid because it looks like impulsive exercising or pretending everything is ok. The risk of harm is run when stories about eating disorders only feature emaciated white women and pictures of mirrors and weighing scales, and the diversity of presentations of eating problems and those they effect are not acknowledged.

When recording features about mental health for television, I’ve even felt some pressure to somehow seem or act as though I am “unwell”. Journalists are surprised when I turn up looking like the physically strong yoga teacher that I am, smiling and chatting with all the confidence of a seasoned public speaker. Surely this means then that I’m recovered from my issues, and that they are thing of the past? Not at all, but I still present a challenge to their idea of what someone with mental health problems might look like.

The truth is that mental health problems come in all shapes, sizes, colours, bodies, genders, religions and sexualities. Not only is there an over-reliance on certain images to represent mental health problems. The air of doom, gloom and seriousness in media coverage of mental health - as though it is something unordinary, special and needing to approached with a hypersensitivity bordering on piousness - only leads to a further reinforcement of narrowly prescribed representations of mental health. This goes against public campaigns such as Time to Change which empower people from a diverse range of backgrounds to show us that mental health is everyones’ business. I’d love to see the day when mental health stories aren’t just accompanied by head-clutchers and scenes of anguish, as important as these experiences are. Bring on the pictures of mothers flashing a “holding it all together” smile and elite athletes crossing the finishing line; bankers in the city toasting another cocktail and people on holiday snapping Instagram pictures of their “best life”. Mental health problems can be at their cruellest when they are invisible. Let’s not allow the media to make those experiencing mental health problems become invisible to our eyes too.